Asked: Where do you think a Justice Barrett would take the court?
HiAP version: Where would a Supreme Court Justice Barrett’s rulings take population, community, and individual health?
Obviously, one cannot forecast what cases will come before the court in the mid- to distant future. We know that Barrett is also an ‘originalist’ rather than a ‘textualist’. So we might ask: What is the impact on health that a legal position of originalist might have, as compared to other positions (e.g. textualist, or Renquist’s concern with just decisions) a supreme court justice might espouse? This is a rather theoretical question, which is not the point of a presidential debate, so I will leave it to the side for now.
Instead, we do know that the ACA (Obamacare) has come before the court in the past, and is likely to do so again. A follow-up question explicitly pointed this out: “Over the last four years you have promised to repeal and replace Obamacare but you have never in these four years, come up with a plan, a comprehensive plan, to replace Obamacare. So my question sir is, what is the Trump healthcare plan?”
This was a perfect opportunity for Trump and Biden to lay out their respective visions of a health in all policies approach, in concrete detail as it impacts families and individuals on a financial and legally accountable level. I favour a medical system to which all within our borders have access, funded by taxpayers -- of whom the top 1% would be the biggest contributors -- as a contribution to the common good.
In terms of regulation, pharmaceutical companies would be reigned in from profiteering off others’ suffering; doctors on salaries rather than per appointment to bring their caseloads to reasonable levels; and the FDA, HHS, EPA, and CDC would all have enhanced authority to ensure the public’s health through transparent regulation.
For individuals and families, it means no more bankruptcy due to medical bills; it means acknowledging that accidents happen even with the best precautions in place and not punishing people for true accidents; and it means a targeted and comprehensive approach to address the root causes of the opiate crisis, child and maternal mortality, premature death and disability among working men, and providing a community safety net that allows for the inherent vulnerability we all face to illness, dependency, and age.
Alternative questions from the first presidential debate to illustrate a Health in All Policies approach
It’s been some time since I’ve updated my website, and I will post items from this past year over the next few weeks. I will begin with a more recent item: What would the presidential debate have looked like had a Health in All Policies (HiAP) approach been central to the questioning?
HiAP may seem to be a non-partisan approach to political decision-making, but it is in fact very politically divisive. For me, a Health in All Policies mindset is one aspect of a holistic, consistent ethic of life approach to envisioning our civic communities. (I write about that approach in another post.)
The debate on 29 September 2020 consisted of seven principal questions: 1) The Supreme Court; 2) the COVID-19 pandemic response; 3) the economy; 4) the issue of race; 5) why the candidate is the best; 6) climate change; and 7) election Integrity. Each of these main topics had sub-questions, which I’ve pared down for the sake of space. I will address each question as a separate, short post. My focus will be (mostly) on how the questions could be framed in terms of HiAP, rather than an analysis of candidates’ positions or on concrete answers from an HiAP perspective.
Jason Johnson Peretz is an Oxford trained Medical Anthropologist and Clinical Research Coordinator at the University of California, San Francisco.